Serum Ischemia-modified Albumin Levels Research Articles

Oxidant and antioxidant balance in children with bacteremia.

There is a crucial balance between oxidant and antioxidant defense mechanisms. We aimed to evaluate the role of the balance of these systems in children with bloodstream infection. We analyzed prospectively oxidant and antioxidant stress parameters from serum samples of children with BSI besides demographic and clinical data of children. Serum levels of the total antioxidant status (TAS), total oxidant status (TOS), albumin, plasma thiol, disulphide, catalase (CAT), myeloperoxidase (MPO), ischemia-modified albumin (IMA) levels, ferroxidase and arylesterase (ARES) activity were evaluated in both patients and healthy controls. A total of 113 children were evaluated, 50 of them had bacteremia and the remaining 63 were healthy subjects. The median TOS values were 18.5 μmol H2O2/L and 13.1 μmol H2O2/L in patient and control groups, respectively with a statistically significant difference between groups. The mean serum IMA levels were 0.8 ± 0.1 absorbance unit (ABSU) in patients and 0.5 ± 0.09 ABSU in control, the difference between groups was statistically significant. The native thiol, total thiol levels and the disulphide levels were significantly lower in the patient group as compared with the control group. The myeloperoxidase level was 136 U/L in patients and 107 in controls with a statistically significant difference between groups. TOS, IMA, MPO, and particularly plasma thiols seem good candidates for accurate diagnosis of bacteremia in children.

Oxidative stress parameters in patients with ascending aortic dilatation

Background/aimThis study aimed to determine plasma thiol, disulphide, and serum ischemia-modified albumin (IMA) levels and ferroxidase activity in patients with ascending aorta dilatation (AAD) in comparison to those without AAD and to evaluate the predictive value of these oxidative stress parameters for AAD.Materials and methods This study was designed as a cross-sectional study of 184 patients who applied to our cardiology clinic. Our study population consisted of patients with AAD (n = 85) and without AAD (n = 99). A spectrophotometric method was used to determine plasma thiol, disulphide, and serum IMA levels and ferroxidase activity.Results The native thiol and the total thiol levels were significantly higher in the control group than the AAD group (P < 0.001), whereas the disulphide and IMA levels and the ferroxidase activity were similar between the groups. The native thiol and the total thiol levels were inversely and significantly correlated with ascending aortic diameter (r = –0.38, P < 0.001; r = –0.39, P < 0.001; respectively). The left ventricle mass and the total thiol levels were independent predictors of ascending aortic diameter (β= 0.223, P = 0.02; β= –0.340, P < 0.001; respectively).Conclusion Among oxidative stress parameters including thiols, disulphide, IMA, and ferroxidase activity, only the lower total thiol levels appear to confer a high risk for AAD development. Along with the proven diagnostic imaging methods, thiol levels may be helpful to diagnose and stratify patients with AAD.

The relationship between oxidative stress and preeclampsia. The serum ischemia-modified albumin levels and thiol/disulfide homeostasis

Objective:Preeclampsia (PE) is a dangerous complication of pregnancy and still a major cause of maternal-fetal morbidity and mortality. Its etiology remains largely unknown, but researchers have suggested oxidative stress-mediated inflammation for the same. The purpose of this study is to investigate the relationship between oxidative stress and PE as well as the usability of oxidative stress indicators such as serum ischemia-modified albumin (IMA) levels and thiol/disulfide balance in the prediction of PE.Materials and Methods:The study included 47 pregnant women with PE and 57 healthy pregnant women. We measured their serum IMA, native thiol, total thiol, and disulfide levels. Additionally, we determined the optimal cutoff values via the receiver operating characteristic curve analysis.Results:There were no differences between the two groups with respect to the maternal age, body mass index, gravida, and parity. The native and total thiol levels were found to be low when the disulfide and IMA levels were high in the patients with PE (p<0.05). When the IMA level was corrected by the albumin level (IMAR), the significant difference between the two groups disappeared. We also found that the native and total thiol concentrations were correlated with the systolic and diastolic blood pressures. The optimal cut-off values calculated for the prediction of PE were as follows: 178.45 µmol/L (with sensitivity of 72% and specificity of 83%) for native thiol, 232.55 µ mol/L (with a sensitivity of 75% and specificity of 85%) for total thiol, and 29.05 µmol/L (with sensitivity of 65% and specificity of 72%) for disulfide.Conclusion:The balance of thiol/disulfide may play a role in the pathogenesis of PE and could be used as a biological marker for PE.

Evaluation of the effect of chiropractic manipulative treatment on oxidative stress in sacroiliac joint dysfunction.

This study aims to investigate the effect of chiropractic manipulative treatment on sacroiliac joint dysfunction (SIJD) and its relationship to oxidative stress (OXS) parameters. Thirty-three patients diagnosed with SIJD (20 males, 13 females; mean age 36.3±9.7 years; range, 18 to 60 years) and 30 healthy volunteers (20 males, 10 females; mean age 36.4±12.2 years; range, 20 to 57 years) were included in this cross-sectional, case-control study conducted between February 2017 and September 2017. Manipulation was applied to the patients once a week for a duration of four weeks. The patients were evaluated at pre-treatment and one month after treatment with visual analog scale, SIJD test, and total thiol, native thiol, disulphide, and ischemia-modified albumin (IMA) as OXS indicators. Prior to treatment, we demonstrated that serum native thiol (μmol/L) and total thiol (μmol/L) levels in the patient group were lower compared to control subjects (p=0.03 and p=0.02, respectively). Serum IMA levels were higher in the patient group (p=0.01). There was no change in OXS parameters after manipulative treatment in the patient group. Manipulation is useful in SIJD. Thiol/disulphide homeostasis and serum IMA levels may be used to measure the OXS in patients with SIJD.

Study of Ischemia Modified Albumin as New Potential Diagnostic Biomarker In Acute Myocardial Infarction.

Background: Because of the varied presentation and associated high mortality the identification of patients with acute myocardial infarction is very critical for the patient management and has a bearing on the prognosis. Only about 22% patients admitted to cardiac care centers with chest pain having truly myocardial infarction. Aim: The goal of present study was to assess diagnostic value of serum ischemia modified albumin and compare it with sensitive cardiac troponin I and Creatine Kinase-MB in acute myocardial infarction. Methods: A diagnostic case control study was conducted on 102 patients presenting to the Emergency Department within 6 hrs of acute chest pain and 115 healthy age and sex matched volunteers formed the control group. Serum ischemia modified albumin level was estimated by albumin cobalt binding test using digital spectrophotometer, while troponin I was measured by immunofluroscence assay and creatine Kinase-MB was determined by immunoinhibition method. The sensitivity and specificity of ischemia modified albumin, troponin I and creatine kinase-MB for detection of acute myocardial infarction were analyzed. The results of ischemia modified albumin, troponin I and creatine kinase-MB alone and in combination were correlated. Results: Ischemia modified albumin (p&lt;0.05) and troponin I (p&lt;0.001) concentrations were significantly higher in acute myocardial infarction than healthy controls. Sensitivity, specificity, positive predictive value and negative predictive value of ischemia modified albumin for detection of acute myocardial infarction was 88.24%, 93.91%, 92.78% and 90.00% compared to 86.27%, 93.04%, 91.67% and 88.43% respectively for the troponin I and 78.43%, 100%, 100%, and 83.94% for creatine kinase-MB. Combined use of ischemia modified albumin, troponin I, creatine kinase-MB significantly enhanced the sensitivity to 96%. The area under the receiver operating characteristic curve of ischemia modified albumin in acute myocardial infarction was 0.90. Conclusion: Ischemia modified albumin is a new potential diagnostic biomarker used together with other gold standard cardiac biomarkers can improve early diagnosis of acute myocardial infarction.

Serum Ischemia-Modified Albumin, Fibrinogen, High Sensitivity C- Reactive Proteins in Type-2 Diabetes Mellitus without Hypertension and Diabetes Mellitus with Hypertension: A Case-Control Study.

The objective of this study was to determine the levels of serum ischemia-modified albumin (IMA), fibrinogen (FIB) and high sensitivity C-reactive protein (hs-CRP) in type 2 diabetes mellitus (T2DM) patients with hypertension (HT) (DMT2HTN) and without HT (DMT2). Also, their association with certain biochemical and physical factors were studied to identify possible risk factors that lead to cardiovascular complications. Fasting blood samples were collected from 35 DMT2 or DMT2HTN patients each to analyze differences in serum and plasma levels of IMA, hs-CRP, FIB, total cholesterol (TC), high and low density lipoproteins (HDL and LDL), triglyceride (TG), hemoglobin A1c (HbA1C), glycated hemoglobin and creatinine. In DMT2 and DMT2HTN patients, IMA, hs-CRP, FIB, TC, TG, HDL, LDL, glycated hemoglobin and creatinine levels, including body mass index (BMI) and waist-to-hip ratio (WHR), were significantly higher relative to healthy controls. In addition, the levels of IMA, hs-CRP and FIB levels showed a strong link to BMI, WHR, TC, TG, LDL and glycated hemoglobin. Lastly, both DMT2 and DMT2HTN patients demonstrated a significant reduction in HDL. DMT2 and DMT2HTN patients have a greater risk of developing cardiovascular related complications. This study suggests that quantifying hs-CRP, IMA and FIB levels can help diagnose the risk of developing complications during the early stages of metabolic and cardiovascular disease. Overall, the specific risk factors may be used for early identification of cardiovascular complications to decrease mortality and morbidity in T2DM patients.

Oxidative Stress in Children with Cutaneous Mastocytosis.

Background: Thiols and ischemia-modified albumin (IMA) are novel biomarkers for the evaluation of the oxidative stress (OS) that has been associated with the pathogenesis of various neoplastic and inflammatory diseases. The aim of this study was to find out the dynamic thiol-disulfide homeostasis and IMA levels in patients with cutaneous mastocytosis (CM) to demonstrate the presence of the OS. Methods: A total of 36 patients with CM and 27 age- and sex-matched healthy participants were included in this study. Serum thiols and IMA levels were measured and compared between the 2 groups. Results: Levels of native thiol, total thiol, disulfide, disulfide/native thiol, disulfide/total thiol, native thiol/total thiol, and IMA were similar in both patients with CM and the control group. No significant difference was found with regard to mediator-releasing symptoms, clinical types, and remission status between the OS markers (thiol/disulfide variables and IMA levels) of the patients (P > 0.05). Conclusions: To our knowledge, this study is the first study in the literature that investigated thiol-disulfide homeostasis and IMA levels in pediatric patients with CM. Our study indicated that OS plays no role in the course of the pediatric CM.

The Diagnostic Values of Ischemia-Modified Albumin in Patients with Acute Abdominal Pain and Its Role in Differentiating Acute Abdomen.

Aim The aim of this study was to evaluate the diagnostic value of serum ischemia-modified albumin (IMA) levels in patients presenting to the emergency department with acute abdominal pain and its use in differentiating acute surgical abdomen. Methods This single-center prospective cross-sectional study included 334 adult patients who presented to the emergency department. These consisted of 194 patients (Group 1) with nontraumatic abdominal pain commencing in the preceding week, who were definitely diagnosed and either hospitalized in a specific department or planned for discharge, and a control group of 140 patients (Group 2). Results The mean IMA value of the patients diagnosed with acute appendicitis was statistically significantly higher than that of the control group. The mean IMA value of the patients diagnosed with acute appendicitis, ovarian pathologies, and gastritis-peptic ulcer was statistically significantly higher than that of the nonspecific abdominal pain group. Conclusion Serum IMA levels can be used as a diagnostic marker in patients with acute appendicitis. Furthermore, serum IMA levels in patients presenting to the emergency department with abdominal pain may be indicative of patients requiring surgery or of complicated cases, particularly in terms of acute appendicitis and ovarian pathologies.

Ischemia-modified albumin as a possible marker of oxidative stress in patients with telogen effluvium

BackgroundTelogen effluvium is the most common form of non-scarring alopecia characterized by diffuse hair loss. Ischemia-modified albumin is a marker of oxidative stress and inflammation. ObjectiveThe aim of this study was to compare the levels of ischemia-modified albumin of telogen effluvium patients with healthy controls. MethodsNinety-one patients diagnosed with telogen effluvium and 35 healthy volunteers were included in the study. Serum ischemia-modified albumin level was determined by a fast-colorimetric method, and albumin cobalt binding test. The results were evaluated statistically. ResultsThere was no statistically significant difference between the serum albumin values of patient and control groups (p=0.739). Serum ischemia-modified albumin values were significantly higher in the patients with telogen effluvium than healthy controls (p<0.001). Study limitationsBody mass index values of the patient and control groups could not be calculated. ConclusionsTo the best of the authors’ knowledge, this is the first clinical study to investigate the role of oxidative stress in the pathogenesis of telogen effluvium using ischemia-modified albumin as a biomarker. Based on the results of the present study, it can be considered that oxidative stress plays an important role in the pathogenesis of telogen effluvium. There is a need for further studies to support the results of this study, to demonstrate the possible effects of oxidative stress, and to investigate the other oxidative stress markers in the pathogenesis of telogen effluvium.

Does ischemia-modified albumin level predict severity of obstructive sleep apnea?

Ischemia-modified albumin (IMA) is a newly recognized marker of chronic inflammation used to evaluate oxidative stress status in patients with various diseases. We explored the possible relationship between IMA levels and obstructive sleep apnea (OSA). In this retrospective study, 169 of 216 sequential patients being evaluated for suspicion of OSAS met inclusion criteria. Polysomnography confirmed OSA in 86 patients (51%) while 81 patients (49%) without OSA were categorized as control subjects. All study participants were tested for blood IMA level, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) level, and red blood cell distribution width (RDW). The serum IMA level was significantly higher in patients with OSAS than controls (p = 0.008). The serum IMA level increased significantly as OSAS severity increased (r = 0.50, p < 0.001) and was positively correlated with the AHI (r = 0.41, p < 0.001), CRP level (r = 0.31, p = 0.004), body mass index (r = 0.24, p = 0.022), RDW (r = 0.31, p = 0.03), oxygen desaturation index (ODI) (r = 0.22, p = 0.02), and negatively correlated with the hemoglobin concentration (r = - 0.28, p = 0.04) and minimum hemoglobin oxygen saturation (SpO2) (r = - 0.25, p = 0.02). Receiver operator curve (ROC) analysis showed that the optimal serum IMA, CRP, RDW, and NLR values were not different for predicting OSAS diagnosis (areas under the curves (AUC) = 0.62, 0.59, 0.60, and 0.43, respectively). However, the serum IMA level was superior in reflecting OSAS severity (AUC = 0.78) compared to CRP, RDW, and NLR values (AUC = 0.61, 0.53, and 0.51, respectively) (all p < 0.001). Like other markers of inflammation, blood IMA levels were significantly elevated in patients with OSA. However, blood IMA level was a better predictor of disease severity than the other markers.

The Significance of Thiol/Disulfide Homeostasis and Ischemia-modified Albumin Levels in Assessing Oxidative Stress in Obese Children and Adolescents

Objective:There is an association between obesity and several inflammatory and oxidative markers in children. In this study, we analyzed thiol/disulfide homeostasis and serum ischemia-modified albumin (IMA) levels for the first time in order to clarify and determine the oxidant/antioxidant balance in metabolically healthy and unhealthy children.Methods:This study included obese children and healthy volunteers between 4-18 years of age. The obese patients were divided into two groups: metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). Biochemical parameters including thiol/disulfide homeostasis, and IMA concentrations were analyzed.Results:There were 301 recruits of whom 168 (55.8%) were females. The obese children numbered 196 (MHO n=58 and MUO n=138) and healthy controls numbered 105. No statistically significant difference could be found in ages and genders of the patients among all groups (p>0.05, for all). Native thiol (SH), total thiol (SH+SS), and native thiol/total thiol (SH/SH+SS) ratio were statistically significantly lower in the MUO group than the control group (p<0.001, p=0.005, and p=0.005; respectively). Disulfide (SS), disulfide/native thiol (SS/SH), disulfide/total thiol (SS/SH+SS) and IMA levels were statistically significantly higher in the MUO group than the control group (p=0.002, p<0.001, p<0.001, and p=0.001, respectively).Conclusion:Chronic inflammation due to oxidative stress induced by impaired metabolic parameters in MUO children caused impairment in thiol redox homeostasis. Our data suggested that the degree of oxidant imbalance in obese children worsened as obesity and metabolic abnormalities increased. It is hypothesized that thiol/disulfide homeostasis and high serum IMA levels may be reliable indicators of oxidant-antioxidant status in MUO children.

The Association of Ischemia Modified Albumin with Osteoarthritis Progression.

We suggested a relationship between increased serum IMA (ischemia-modified albumin) levels and cartilage degeneration. We proposed that the increased serum levels of IMA was due to the oxidative stress mechanism against ongoing cartilage degeneration in osteoarthritis (OA) and thus may be associated with the progression of OA. We aimed to investigate serum IMA levels in OA patients and determine whether any changes in IMA levels are useful as a marker in increased OA. A prospective case-control study was carried out, which included 110 patients (55 patients with OA and 55 healthy controls). Serum samples obtained from all participants and IMA levels were determined by spectrophotometric method. Compared with controls, OA had significantly higher IMA and IMA/albumin (IMAR) levels (0.732 ± 0.078 vs. 0.773 ± 0.080, p = 0.008; 0.188 ± 0.20 vs. 0.176 ± 0.21; p = 0.011). Multivariable logistic regression analysis revealed rising IMA and IMAR levels were independently associated with OA (OR: 1.755, 95% CI: 0.655 - 4.700, p = 0.009 and OR = 3.021, 95% CI: 0.258 - 3.525, p = 0.015). The current study suggests that increased levels of IMA are associated with OA and are a probable predictive risk marker for the progression of OA.

Serum ischemia modified albumin and dynamic thiol/disulfide homeostasis in early- and late-onset preeclampsia

Aim: In the present study, we aimed to evaluate serum IMA, IMA/albumin ratio, and DTDH levels in patients with early- and late-onset PE compared to healthy controls.Impaired homeostasis between oxidant and antioxidant mechanisms, inflammatory processes, and endothelial dysfunction play a key role in the pathogenesis of preeclampsia (PE). Serum ischemia modified albumin (IMA) and dynamic thiol/disulfide homeostasis (DTDH) levels are elevated in the presence of inflammation, oxidative stress, and endothelial dysfunction. Material and Methods: A total of 24 patients with early-onset PE and 62 patients with late-onset PE were included.The control group consisted of 46 healthy controls with similar gestational weeks. Serum samples were collected and IMA, albumin, and native, total, and disulfide thiol levels analyzed. Corrected IMA/albumin ratios were also calculated.Results: Disulfide levels, disulfide/native and disulfide/total thiol levels were higher in patients with early-onset PE compared to late-onset patients(p=0.008, p=0.022, and p=0.021, respectively). However, there was no significant difference between the late-onset PE patients and late-onset PE controls. Although there was no significant difference in the IMA levels between the patient and control groups, the IMA/albumin ratio was higher in the early-onset and late-onset PE patients, compared to the control group. However, there was no significant difference between the early-onset and late-onset PE patients.Conclusion: Our study results showed increased disulfide levels, disulfide/native thiol, disulfide/total thiol and IMA/albumin ratio in the early-onset PE patients, indicating increased oxidative stress in the pathogenesis of PE. In the late-onset PE patients, there was an increase only in the IMA/albumin ratio. However, further large-scale, prospective studies are needed to confirm the diagnostic value of these markers in the clinical practice.

Ischemia Modified Albumin and C-Reactive Protein in Children with β-Thalassemia Major

Background: Beta-thalassemia is a hereditary haemoglobinopathy caused by defective hemoglobin (Hb) β-globin synthesis, leading to excess α-globin chains that cause hemolysis and impair erythropoiesis. Ischemia modified albumin (IMA) is not a signal protein and not generated in pro-inflammatory state alone but rather an end product of oxidative stress. Objectives: The aim of the study was to evaluate ischemia modified albumin (IMA) and C-reactive protein (CRP) in children with β-thalassemia major and its relation to different iron chelators. Patients and Methods: The study was carried on 40 children diagnosed as beta-thalassemia major recruited from the outpatient clinic and the pediatric department, at Al-Zahraa University Hospital, Faculty of medicine for Girls, Al-Azhar University and EL Minia Insurance Hospital. They were 20 male and 20 female, aged from 4 - 11 years. Another 40 apparently healthy children age and sex matched as control group. CRP and IMA were determined for all participants. Results: There were significant increases in serum CRP, IMA and ferritin levels in patients group compared to control group. There were significant decreases of IMA and CRP levels of thalassemic patients on chelation deferiprone (DFP) compared to deferasirox (DFX) P-value (Conclusion: IMA, CRP and Serum ferritin were higher in children with β-thalassemia major than controls. Moreover, IMA and CRP levels in thalassemic children on deferiprone (DFP) were significantly lower compared with children on deferasirox (DFX). So it could be considered as useful markers in the follow up assessment of thalassemic patients for early detection of complications.

Ischemia Modified Albumin and D-dimer in the Diagnosis of Testicular Torsion: An Experimental Model.

We aimed to investigate the potential early diagnostic value of ischemia modified albumin (IMA) and D-dimer in testicular torsion. A total of 42 prepubertal Wistar-Hannover rats (26-30 days old, weighing 75-125 grams) were used in the study. They were randomly divided into 2 groups as torsion (21 rats) and control (21 rats). Both torsion and control groups were subdivided into three subgroups as 30th, 120th and 240th minutes. Intraperitoneal injection of 70 mg/kg ketamine (Ketalar, Pfizer, Istanbul, Turkey) plus 10 mg/kg of xylazine (Rompun, Bayer, Istanbul, Turkey) were used for general anesthesia. In the control group, scrotal incision was made and the left testis gently extracted. Then, intracardiac blood and testicular tissue were obtained at 30th, 120th and 240th minutes. In torsion group, testicular ischemia was achieved by rotating left testis 720° clockwise and maintained by fixing the testis. Blood and testicular samples were obtained at 30th, 120th and 240th minutes. All animals were sacrificed after completion of the study. There was a statistically significant difference between the IMA and D-dimer levels at 30th, 120th and 240th minutes of torsion group when compared with the control group (p = .001). When compared in terms of pathological changes at 30th, 120th and 240th minutes, significant difference was found for all 3 periods (p = 0.039, p = 0.014, p = 0.03, respectively). The D-dimer and IMA estimated torsion with reasonable accuracy [Area under the curve (AUC)= 0.771 (p = 0.003, 95% confidental interval: 0.620-0.922) and AUC = 0.706 (95% confidental interval: 0.549-0.863, p = 0.022), respectively. The elevated D-dimer and IMA serum levels observed in the experimental testicular torsion modelseem to have a potential role as a serum marker in the early diagnosis of testicular torsion.

Ischemia-modified albumin (IMA) and dynamic thiol-disulfide homeostasis in patients with postherpetic neuralgia

Abstract Background Ischemia-modified albumin (IMA) is an isotype of albumin that increases under oxidative stress, and plasma thiols are main defense mechanisms against oxidative stress. The objective of this study was to investigate thiol-disulfide homeostasis and serum IMA levels in postherpetic neuralgia (PHN) patients. Methods A total of 29 PHN patients and 30 healthy controls were included in the study. Serum total and native thiol concentrations and serum disulfide concentration were measured using the method described by Erel and Neselioglu. The albumin cobalt binding test was used to measure serum IMA levels. Results Serum IMA levels were 1.21 ± 0.58 AU and 0.75 ± 0.09 AU in the PHN and control groups, respectively (p &lt; 0.001). Serum total thiol concentrations were found to be 421.62 ± 90.28 μmol/L and 598.36 ± 73.63 μmol/L in the PHN and control groups, respectively (p &lt; 0.001). Serum native thiol concentrations were found to be 365.75 ± 92.07 μmol/L and 531.90 ± 72.9 μmol/L in the PHN and control groups, respectively (p &lt; 0.001). Serum disulfide concentrations were found to be 33.23 ± 5.33 μmol/L and 27.93 ± 7.81 μmol/L in the PHN and control groups, respectively (p = 0.003). The native thiol/total thiol ratio was significantly lower, and the disulfide/total thiol and disulfide/native thiol ratios were significantly higher in the PHN group compared to the controls. Conclusions IMA levels are high and dynamic thiol/disulfide homeostasis is disrupted in PHN patients.

Thiol Disulfide Homeostasis and Ischemia-modified Albumin Level in Children With Beta-Thalassemia.

It is well known that increased oxidative stress leads to tissue damage in beta-thalassemia (β-thal) patients. Thiols are one of the most important antioxidant agents, and thiol/disulfide (SH/SS) homeostasis is a novel oxidative stress marker. This study aimed to investigate the relationship of thiol levels, SH/SS homeostasis, and ischemia-modified albumin (IMA) in patients with β-thal. A hundred transfusion-dependent β-thal patients and 41 healthy controls were included in the study. Native thiol, total thiol, disulfide, catalase, and IMA levels were significantly higher in the β-thal group compared with the control group (P<0.02). There were no correlation between serum ferritin level and SH/SS homeostasis, and weak positive correlations were found between serum ferritin and IMA (r=0.242, P=0.022). Our study results suggest that antioxidant systems try to compensate for peroxidative damage in the patients' group and serum IMA level was found increased because of increased oxidative status. To the best of our knowledge, there has been no report evaluating plasma dynamic SH/SS homeostasis in β-thal patients.

Evaluation of the Association between Ischemia Modified Albumin (IMA), Glycemic and Lipid Status in Diabetic Nephropathy

Introduction: Hyperglycemia induced oxidative stress in Type 2 Diabetes Mellitus modify various biomolecules to cause Diabetic Nephropathy (DN). IMA (Ischemia-Modified Albumin) is one such oxidative stress marker already examined in various clinical events but have not yet been evaluated in different stages of DN.&#x0D; Aim: To estimate and assess the relationship of IMA with glycemic status and lipid parameters in all stages of DN.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Study was conducted at Department of Biochemistry, Kasturba Medical College Hospitals, Mangaluru conducted between 2014 and 2015.&#x0D; Materials and Methods: There were 60 type 2 diabetic cases and 30 healthy controls. Diabetic cases were further categorized into three equal groups on the basis of UACR (urine albumin-creatinine ratio), DN stage I having UACR less than 30 mg/g, DN stage II having UACR 30 to 300 mg/g, and DN stage III having UACR ≥ 300 mg/g of creatinine. Using enzyme-linked immunosorbent assay serum IMA level was estimated whereas automated analyzers was used for serum creatinine, HbA1c, urine albumin and urine creatinine analysis.&#x0D; Results: Lowest level of IMA (109 ng/mL) measured in DN stage I, which was significantly different from those in DN stage II (154 ng/mL) and DN stage III (178 ng/mL). The significant positive correlation between IMA and fasting blood glucose, glycated hemoglobin were present in stage II and stage III DN. In this study significant positive correlation of serum IMA to serum total cholesterol, low density lipoprotein cholesterol and negative correlation with high density lipoprotein were revealed in all stage of DN.&#x0D; Conclusion: Current study postulates that early evaluation of serum IMA in diabetic patients with deranged lipid profile will provide an index of nephropathy development. This will help in prognosis and controlling complication in diabetes mellitus.

Serum neopterin and ischemia modified albumin levels are associated with the disease activity of adult immunoglobulin A vasculitis (Henoch-Schönlein purpura).

The aims of the study are to investigate serum neopterin and ischemia modified albumin (IMA) levels in patients with immunoglobulin A vasculitis (IgAV) and evaluate the association of these markers with disease activity and relapse. Thirty-four consecutive adult patients (24 male and 10 female) admitted to the rheumatology clinic and met the IgAV American College of Rheumatology (ACR) criteria were enrolled in this cross-sectional study. Demographic and clinical features of IgAV and a control group were recorded into a predefined protocol. Disease activity was categorized as "remission" or "active" according to Birmingham Vasculitis Activity Score (BVAS). BVAS≥1 was accepted as "active". Serum neopterin levels, high-sensitivity C-reactive protein (hsCRP) and IMA were evaluated according to BVAS and compared to the healthy control group. Serum median (interquartile range) neopterin, IMA levels and hsCRP were higher in the study group than in control group (2.01 [12.5] ng/mL vs 1.77 [1.37] ng/mL, 0.67 [0.2] ng/mL vs. 0.43 [0.17] ng/mL, 5.6 [17.1] mg/L vs. 1.55 [1.6] mg/L, P=.095, P<.001 and P=.002, respectively). When evaluated according to BVAS, IMA and hsCRP levels were significantly higher in the group with active disease (0.77 [0.12] vs 0.61 [0.13] and 14.85 [4.6], P=.009 and P=.03, respectively). Serum neopterin levels were significantly higher in the active group compared to BVAS (18.95 [32.36] vs 1.63 [1.48], P<.001). Oxidative stress is important in IgAV pathogenesis. Roles of hsCRP, neopterin and IMA as potential markers of diagnosis and disease activity seem to be worth studying in future studies with larger study groups.

Evaluation of ischemia modified albumin levels in major depression patients

Aim: Depression is an important public health problem, which has been associated with an antioxidant defense system. Ischemia-modified albumin (IMA) is a new biomarker that measures ischemia. The aim of this study was to evaluate IMA levels as a new parameter related to oxidative stress in patients with major depressive disorder (MDD). Methods: This cross-sectional case-control study included 59 patients aged between 18-65 years who were admitted to our psychiatry outpatient clinic between June 2018-December 2018, diagnosed with MDD and had not used psychotropic drugs for 3 months. In addition, 59 age and sex matched healthy controls were included in the study. Serum IMA and albumin levels were measured in blood samples taken from each patient and from control groups. Hamilton Depression Rating Scale (HDRS) was applied to the subjects to evaluate the depression level. Results: Among the MDD group, 27 patients (45.8%) were male and 32 (54.2%) were female. The number of males and females in the control group were 29 (49%) and 30 (51%). Mean ages of the patients in MDD and control groups were 39.40 (12.20) and 38.67 (9.29) years, respectively. No statistically significant difference was found between the groups in terms of age and gender (P=0.942 and P=0.714, respectively). The mean IMA level of MDD and control group patients were 0.84 (0.39) and 0.82 (0.30), respectively; the difference was statistically significant (P<0.001). There was also a statistically significant difference between the albumin levels of the two groups (P=0.01). Correlation analysis showed a positive correlation between serum IMA levels and HDRS scores (r=0.235, P=0.008). Conclusion: In our study, IMA levels of MDD patients were significantly higher than that of the control group. This result may be an indicator of increased oxidative stress in patients with depression. There is little data in the literature evaluating IMA levels in psychiatric disorders.